ArticleFrontiers in medicine2026
Successful conservative treatment of contralateral recurrent ectopic pregnancy with high β-HCG after unilateral salpingectomy: a case report.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Ectopic pregnancy (EP) is a common gynecological emergency, and its clinical management requires comprehensive consideration of β-human chorionic gonadotropin (β-HCG) level, mass size, fertility needs, and vital signs. Methotrexate (MTX)-based conservative treatment is mostly suitable for stable patients with β-HCG < 5,000 IU/L and no active bleeding, while surgical treatment is routinely recommended for those with β-HCG > 5,000 IU/L. Case presentation: This article reports a 30-year-old patient with ectopic pregnancy (G4P0) who had a history of laparoscopic left salpingectomy due to ectopic pregnancy and two previous artificial abortions. The initial β-HCG level on admission was 5,823 IU/L, which later increased to 6,609 IU/L. The patient had stable vital signs but a strong demand for fertility preservation. She refused surgical treatment and received combined traditional Chinese and Western medicine conservative treatment. After the first MTX administration, β-HCG increased to 8,516 IU/L, and then gradually decreased after continued conservative treatment. At discharge, β-HCG decreased to 1,067.0 IU/L, and follow-up in the outpatient clinic showed that β-HCG turned negative. Conservative treatment was successful without severe complications such as ectopic pregnancy rupture or massive hemorrhage. Conclusions: This case demonstrates that in a carefully selected patient with stable vital signs, absence of rupture, strong fertility preservation desire, and good compliance, conservative management with repeated MTX doses may be a feasible alternative to surgery even when initial β-hCG exceeds 5,000 IU/L. However, this approach requires strict patient selection, intensive monitoring, and preparedness for emergency surgical conversion. The individual contribution of Traditional Chinese Medicine (TCM) to the successful outcome cannot be ascertained from this single case.
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